Building Trust Is Key To Ensuring Farmworker Access To COVID Testing, Vaccine
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For more than a decade, Saraí has been a farmworker, cultivating corn and soybeans in the fields of central Illinois. She moved to the U.S. from Mexico to find work that would allow her to better support her family.
Being an agricultural worker “is the most beautiful thing,” Saraí says in an interview in Spanish. She asked to be identified only by her first name because she’s undocumented.
Saraí hasn’t been in the fields lately, though, instead focusing on getting her three kids through virtual schooling. And while she has been spared from the virus, Sarai knows many others who’ve gotten sick. She says the pandemic has made the past year a sad and difficult one for many agricultural workers.
There have been tens of thousands of COVID-19 cases and hundreds of deaths reported among workers on the nation's farms and in meat processing plants. Because there isn’t an official tracking system in place, these figures — based largely on media reports — are likely an undercount.
And yet, agricultural workers like Saraí struggle to access the most basic tool to fight the spread of the virus: testing.
Saraí, for example, has only been tested once since the start of the pandemic. The nearest testing site is the next town over, and without a car of her own or a public transportation option, she had to borrow a friend’s vehicle to get there.
“Many farmworkers are both working and living in sometimes isolated rural regions of the country,” says Diana Tellefson Torres, executive director of the California-based United Farm Workers Foundation.
In addition to living far from testing sites, these workers often lack access to reliable information in their language and have a general mistrust of the health care system. And missing work to get a test, or to isolate or quarantine, could be financially devastating, she says.
The rollout of coronavirus vaccines provides hope that the end of the pandemic is near. But the virus is still spreading across the U.S. and efforts to expand access to testing and build trust with the farmworker community are still needed, Tellefson Torres says.
She says these efforts will also be critical for ensuring these hard-to-reach, vulnerable populations have access to the vaccine when the time comes.
‘They lack that kind of access’
Early on in the pandemic, Gilberto Rosas, an anthropologist at the University of Illinois at Urbana-Chamapgin, was struck by how easy it was for him — a work-from-home professor — to get a test compared to other more vulnerable workers in nearby towns.
Rosas works in Champaign-Urbana, which has its own mass testing program for university students and employees. The campus is just 15 miles south of the Village of Rantoul, where outbreaks at a meat processing plant and a hotel housing migrant farmworkers were among the worst in the area last year.
“We can walk down two flights of stairs, go out the back door and we can get testing,” Rosas says. “Whereas these people who are at the forefront — who work in the fields, who work in the plants — they lack that kind of access.”
So he and several colleagues, who had set out to study what was causing the virus to spread among the agricultural community, decided to do something to address the issue of testing access.
Since they are researchers — and not medical professionals — they teamed with medical clinics in the area to organize pop-up coronavirus testing events in Rantoul.
They advertise the events in English and Spanish. The group has also tried to leverage long-standing community connections to bolster turnout, reaching out to churches and organizations that cater to the area’s immigrant and agricultural workforce.
But they’ve been frustrated by low attendance at many of their testing events.
At one event held the Monday before Christmas outside a community center, for example, only 15 people came to get a test. Four people tested positive — a high rate.
Sofia Bolanos Robinette suspects more people don’t turn out for testing, even when it’s available at convenient times and locations, because a positive test can be financially devastating.
Bolanos Robinette has worked with farmworkers for the past 10 years as part of the Illinois Migrant Education Program. She recently came on board as a researcher -- alongside Rosas and the other University of Illinois anthropologists — to study issues like barriers to testing.
She recalls helping last summer with a coronavirus testing effort aimed at farmworkers who travel to the region for seasonal work. The clinic tried to make it as easy as possible for the workers to attend by setting up during off-hours right outside the migrant camp housing them.
“But some of them said they didn't even want to take the test, because in the case they get back [a positive result], they will have to stop working,” Bolanos Robinette says. “And then that means for them, they will not get any money for at least two weeks.”
That’s a big deal, she says, especially for farmworkers who earn the bulk of their yearly income doing this work.
For low-wage farmworkers, “every penny counts,” says Tellefson Torres of the United Farm Workers Foundation. Simply put, they have no safety net.
“When you have to worry about putting food on your own table for your family, sometimes that is the focus because there isn't another option,” Tellefson Torres says.
There’s also fear, she says, of seeking out help from government agencies, especially among undocumented workers. They may worry that seeking a coronavirus test could jeopardize their efforts to obtain a visa — which is not true.
Despite lower-than-ideal turnout at the pop-up testing events in Rantoul, University of Illinois anthropologist Ellen Moodie — another member of the group organizing the events — sees results. She says attempts to host “a few small-scale testing events, irregularly scheduled and located in different sites” have made a difference for the handfuls of people who might not otherwise have known they had the virus.
Her personal view, however, is that the U.S. needs a comprehensive strategy to address the virus and protect vulnerable workers. Many public health experts have called on the Trump administration to execute such a strategy since the start of the pandemic, and President Joe Biden has said he will prioritize it in his first 100 days.
In a document published Thursday, Biden outlined a COVID-19 strategy that focuses on boosting the production and distribution of vaccines. It includes plans to address supply shortfalls for testing materials, implement stronger worker safety guidelines, expand emergency paid leave and otherwise strengthen the social service safety net.
Building trust with members of the agricultural worker community remains critical, Tellefson Torres says, not just to get more people to show up for testing — but also to eventually show up for the vaccine.
At a recent virtual town hall event hosted by the United Farm Workers Foundation, Tellefson Torres says she heard from many farmworkers across the country who are eager to get the vaccine. But others have reservations.
The biggest concern she heard was about the potential cost, especially for the many workers who lack health insurance. Tellefson Torres says her organization is working on getting the word out that the vaccine is free for everyone.
Others, she says, worry about vaccine safety. “One of the big challenges is also like, ’What is this vaccine? What does it contain or what are you putting in my body?’”
That’s something Saraí, the farmworker in Illinois, worries about too. After finding some information online, she grew concerned about the possibility of adverse reactions, so she isn’t planning to get the vaccine.
But if someone she trusts shows her evidence the vaccine is safe, Saraí says she could change her mind.
Public health administrator Julie Pryde says the Champaign-Urbana Public Health District — which serves an area including Rantoul — plans to work with a federally supported migrant clinic to host mobile vaccination events targeting migrant and seasonal farmworkers.
Tellefson Torres says partnerships like that will be critical to ensure agricultural workers, who have faced so many challenges throughout the pandemic, have equitable access to the vaccine.
“The norms that we have seen prior to the pandemic — of not prioritizing worker health or just basic safety net needs — need to be addressed both by state, local, federal governments and employers,” she says. “We're literally talking about a life-and-death situation here.”